Much of the gender sensitive research in the area of cardiovascular health has focused on sex-related hormone differences. During the first three decades of life women have lower levels of low-density lipoprotein cholesterol than men. It has been argued that the later onset of CHD in women is due to their higher HDL cholesterol levels, attributed to higher endogenous estrogen levels in women[1].
Estrogen and progestrone have been found to reduce lipid accumulation in macrophages from female, but not male donors[2]. On the other hand, estrogen administration increases the levels of triglycerides, coagulation markers (e.g. factor VII) and C-reactive protein.
Another gender related cardiovascular health issue is the importance of gonadal hormones in the development of cardiovascular disease, especially atheroma progression. Researcher suggest the potential for early instigation of gonadal hormones to interact constructively on the development of atherosclerosis[3]. Related to the impact of sex hormones is the higher rate of increase in atherosclerotic lesions amongst women aged 50-70 compared to men of the same age group. This sex-related difference is thought to be due to the effect of plasma estrogen on the lipid profile in men and women[4].
A recent concern regarding the effect of estrogen is the difference between orally administered and ovarian estrogen. Researchers question the difference in the impact of estrogen even within CHD. Although there is research supporting the lowering of LDL cholesterol in women because of estrogen administration, this pharmocologic property does not necessarily hold for endogenous estrogen[1].
Currently there are studies speculating about the benefits and detriments of using estrogen therapy or the value that is placed on estrogen in women's cardiovascular health. Hence, more studies are required regarding hormone therapy to better understand the sex related advantage(s) of pre menopausal women over men in cardiovascular health[5]. Hormone therapy (especially estrogen therapy) has been hot topic of discussion among researchers involved with cardiovascular health and recent findings have only created more questions that are currently under investigation regarding the topic of hormones.
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1. Rossouw, J. (2002) Hormones, Genetic Factors, and Gender Differences in Cardiovascular Disease. Cardiovascular Research, 53: 550-57.
2. McCrohon, J., Nakhla, S., Jessup, W., Stanely, K., Celermajer, D., (1999) Estrogen and Progestrone Reduce Lipid Accumulation in Human Monocyte-Derived Macrophages. Circulation, 100:2319-25.
3. Collins, P., Stevenson, J.C., Mosca, L., (2002) Spotlight on Gender. Cardiovascular Research, 53: 535-37.
4. Redberg, R.F., (1998) Coronary Artery Disease in Women: Understanding the Diagnostic and Management Pitfalls. Medscape Womens Health, 3:1.
5. Buchanan, M., Brister, S., (2000) Sex Related Differences in The Pathophysiology of Cardiovascular Disease: Is There A Rational For Sex-Related Treatments? Canadian Cardiovascular Society Consensus Conference: Women and Ischemic Heart Disease, October 2000: 2/1-2/28.
